Are you one of those people who seem to sprain your ankle all the time?
To some extent, ankle sprains are piece and package to be active.
But if it happens again and again, here’s what can happen and how you can reduce your risk of a recurring ankle sprain.
One sprain can lead to another… and another
A big exam of ankle sprain studies in the review Sports medicine found that most people who play sports or actively train can expect to have a fairly low incidence of ankle sprains per 1,000 hours of training. But he also said:
Women were at higher risk of ankle sprain than men and children than teenagers and adults, with indoor and field sports being the highest risk activity.
The most common type of ankle sprain occurs if the ligaments on the outside of the ankle are stretched or torn when the joint moves beyond the normal range of motion. This is called an inversion or lateral ankle sprain.
Strong evidence of studies suggests that once people sprain their ankle, they are more likely to sprain it again. Like a exam of evidence says so:
a history of lateral ankle sprain is known to disrupt the structural integrity of ligaments and sensorimotor function, likely impairing an individual’s ability to avoid harmful situations.
Some ankle sprains may seem very minor, with almost no swelling or mobility issues. But some people can end up with what’s called chronic ankle instability, where they tend to sprain their ankle over and over again.
Another one exam examining factors contributing to chronic ankle instability
feelings of instability and recurrent ankle sprains (called chronic ankle instability or CAI) have been reported in up to 70% of patients. Further development of CAI has adverse health consequences, including reduced quality of life and early osteoarthritis.
Once an ankle fracture is ruled out, busy hospital emergency departments often send patients home with instructions to put ice on the ankle and not use it for a day or two. . There is often no advice to follow up with a physio for rehabilitation.
This is unfortunate, as evidence suggests that people with a history of ankle sprains are likely to:
Even the other ankle may be at risk
Research suggests that people who sprain their ankle are more likely to have injuries to other joints of the same leg, or even of the opposite leg. A review in the International Journal of Sports Physiotherapy noted “an ankle sprain is related to both reinjury and subsequent injury to the contralateral side”.
Why? It may have something to do with the brain’s tremendous ability to constantly adapt.
As prolonged bed rest or prolonged exposure to microgravity astronauts can cause changes in the brain and how it relates to movement, perhaps our brain is subconsciously compensating after an ankle injury.
This could be, for example, limping or slightly changing the way you walk; maybe you don’t want to subconsciously challenge the ankle for fear of spraining it again. This can put other joints or the opposite limb at increased risk.
This neuroplasticity adds new challenges to the assessment or rehabilitation of an ankle injury, and to the prediction of who may be risk of further injury.
What can you do to reduce the risk of ankle re-sprain?
If you suffer from recurrent ankle sprains, see a physiotherapist. They can teach you how to reduce risk.
Currently, the best evidence for reducing the risk of ankle re-sprain comes down to two main things:
1) Protect the joint with an ankle brace in case of activity
This could mean using a professionally fitted external support brace (not an elastic sleeve). This is a relatively inexpensive and effective means of risk reduction.
2) Use balance exercises and ‘proprioceptive training’
examples of proprioceptive training to understand:
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balancing on each leg, one at a time, while throwing and catching a ball against a wall
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balancing on an ankle disc or a swing board for three to five minutes a day.
These exercises can help strengthen the muscles and ligaments in your ankle. As one review of the literature puts it:
Proprioceptive training is a cost-effective and time-effective intervention that may benefit patients who have previously experienced an ankle sprain during physical activity and may subsequently reduce the risk of further complications.
